There are many different problems that can cause male infertility and for the most of them modern medicine can offer an appropriate treatment. There are many new developed and very effective methods and sperm retrieval techniques to treat male reproductive dysfunction.

There are two different approaches - surgical and non-surgical sperm retrieval techniques. Although non- surgical sperm retrieval techniques are not invasive and thus less traumatic they can simply be not effective in some cases. That is why in most cases these days surgical sperm retrieval techniques are used.

Before the use of sperm retrieval techniques there is a need to perform simple tests of sperm to find the actual problem that causes male infertility. There are many possible cases - for example low sperm volume or low sperm motility. And all these problems have to be treated with different sperm retrieval techniques.

One of the pretty safe and less invasive methods is the percutanrous technique. Two different methods are used these days: PESA (Percutaneous Epididymal Sperm Aspiration) and TFNA (Percutaneous Testicular Sperm Aspiration). PESA surgical operation can be made with general or even with
local anesthesia as long as it is comparatively simple. During the actual procedure a special 21-gauge butterfly needle is inserted into the patient's caput epididymis and then it is gently withdrawn (until fluid enters the needle). And this procedure is repeated until the needed amount of sperm is retrieved.

And the procedure of TFNA was at first used to diagnose azoospermia, but these days an improved technique is used for sperm retrieval. Here a special device is used with a 21-23 gauge needle attached to it and the procedure is pretty similar to PESA. Among this kind of sperm retrieval techniques there is also a so-called percutaneous testicular biopsy. This is a very effective technique with minimal invasive nature.

All the percutaneous sperm retrieval techniques have the same advantages over the open technique - first of all less anesthesia is needed for these procedures and they give less discomfort to the patient. What is also great is that percutaneous sperm retrieval techniques can be easily repeated and they also cost less than microsurgical techniques.

Open techniques of surgical sperm retrieval include TESE (TEsticular Sperm Extraction) and MESA (Microsurgical Epididymal Sperm Aspiration). Of course, all these procedures are more traumatic than percutaneous sperm retrieval techniques, but in some cases such surgery can be the only way to treat the problem. In TESA open testicular biopsy technique is used for sperm retrieval. Special optical magnification devices are used here to make distinction of blood vessels and epididymal tubules. And using MESA the main advantage is that it gives an ability to dissect individual epididymal tubules (and make it under direct vision).

There is also a variation of this technique called Mini-micro-epididymal sperm aspiration which is a combination of MESA and PESA.